Postoperative pain and analgesic requirements after anesthesia with sevoflurane, desflurane or propofol.
BACKGROUND
General anesthetics may have nociceptive actions that affect postoperative pain. In studies evaluating postoperative pain, the effect of general anesthetics on analgesic requirements has not been considered except for one recent study suggesting that propofol anesthesia provides better analgesia after surgery than isoflurane.


METHODS
In this prospective, blind, randomized trial we recorded postoperative analgesic requirements (mg of morphine) and pain scores (visual analog scale in mm) 2, 4, 8, and 24 h postoperatively in patients undergoing abdominal hysterectomy or myomectomy under sevoflurane, desflurane or propofol anesthesia, titrated to maintain Bispectral Index values between 35 and 45. Pain scores were also recorded immediately after transfer to the postanesthesia care unit.


RESULTS
Cumulative morphine consumption did not differ among the three groups 2, 4, 8, or 24 h postoperatively (P = 0.50). The morphine consumed within 24 h postoperatively was 28 +/- 13.8 mg in the sevoflurane group, 25 +/- 11.7 mg in the desflurane group and 27 +/- 16.1 mg in the propofol group. The visual analog scale values at rest or after cough immediately after patient transport to the postanesthesia care unit and 2, 4, 8, and 24 h after surgery did not differ among the three groups (P = 0.40, 0.39, 0.50, 0.47, 0.06 at rest and P = 0.67, 0.45, 0.22, 0.26, 0.29 after cough respectively).


CONCLUSIONS
Morphine consumption and pain 24 h postoperatively did not differ among the sevoflurane, desflurane, and propofol groups.
Fassoulaki
Argyro
A
Department of Anesthesiology, Aretaieio Hospital, 76 Vassilissis Sofias Ave., 11527, Athens, Greece. fassoula@aretaieio.uoa.gr
Melemeni
Aikaterini
A
Paraskeva
Anteia
A
Siafaka
Ioanna
I
Sarantopoulos
Constantine
C
D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous / Q000379:methods; D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D000077335:Desflurane; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008738:Methyl Ethers / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology*; D015742:Propofol / Q000627:therapeutic use*; D000077149:Sevoflurane; D014594:Uterine Neoplasms / Q000601:surgery
D000700:Analgesics; D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D009020:Morphine; D000077335:Desflurane; D007530:Isoflurane; D015742:Propofol